六经气津互化论

气与津皆生于水谷,气生于水,水化于气,津即为水。由于气津互化的密切关系,故任何一方的改变,都会影响到另一方,即所谓水化于气,亦能病气;气生于水,亦能病水。因此,太阳经气可概括为两大功能,即卫外和气化,是由气津互化而体现的;阳明气津之间,表现为相互制约;少阳经的气津互化,关系到少阳气机的条达舒畅及三焦水道的通调运使;太阴脾气的健旺,可使津液化生有源;少阴心肾精血充沛,滋养有时,才可使心肾之气化生有源;而厥阴之气的条达顺畅,又可维持津液代谢的平衡状态。     

A Biomechanical Double Sac (Pericardium-Pebax) for Specially Shaped Artificial Ventricles: A Computerized Study to Evaluate Its Mechanical and Volumetric Properties

Abstract: For original ovoid shaped artificial ventricles. a biomechanical double sac consisting of a biological sac (porcine pericardium) as the blood contact interface and a synthetic sac (Pebax 3533) as the mechanical support to assume systolic-diastolic dynamic constraints was conceived. The volumetric and mechanical properties were assessed with a three-dimensional modeling of Pebax sacs and computerized simulations of their systolic distortions for both right and left ventricular configurations. The stresses and strains of these sacs were represented as quantitative mappings for a maximum end-systolic state and were below the respective threshold values above which the Pebax material is jeopardized for permanent structure impairment. After fatigue tests applied on Pebax strips under the alleged working conditions of Pebax sacs, the material structure was unchanged and maintained its intrinsic mechanical properties. The theoretical maximum stroke volumes were 74.4 cm³ and 62.4 cm for the left and right ventricular configurations, respectively. With these mechanical and volumetric features, the biomechanical double sac concept was considered valid and could be provided for a consequent specific total artificial heart.     

复方通络中药改善肥胖患者血管内皮细胞功能障碍研究

目的观察复方通络中药对单纯性肥胖患者血管内皮依赖性舒张功能障碍的干预效应，探讨其作用机制。方法应用高分辨血管超声检查选择血管内皮依赖性舒张功能障碍[以血流介导的肱动脉扩张率（FMD）表示]肥胖患者（65例），随机分为通络中药治疗组和对照组。治疗组32例，对照组33例。治疗组给予辛香疏络2号胶囊，3g／次，每日3次；对照组给予淀粉胶囊，3g／次，每日3次。共用药12周，分别测定用药前后FMD、肱动脉内径（D0），同时检测辛香疏络2号治疗前后患者血清总胆固醇（TC）、三酰甘油（TG）的变化。结果治疗后治疗组FMD较对照组明显增加（P〈0．01），TC、TG较治疗前及对照组明显下降（P〈0．01）。结论复方通络中药辛香疏络2号胶囊可明显改善肥胖患者血管内皮障碍，调节血脂可能是其改善血管内皮功能机制之一。     

AN AUTOPSY CASE OF PRIMARY ANGIOSARCOMA OF THE PERICARDIUM MIMICKING MALIGNANT MESOTHELIOMA

The pathology of a rare case of primary diffuse angiosarcoma of the pericardium is reported. Grossly, the heart was entirely encased by the pericardial tumor, and the myocardium was only superficially invaded by the tumor. The tumor tissue extended directly to the mediastinum, where the great vessels were embedded in the tumor. A few minute distant metastases were found only in the bilateral lungs and pulmonary hilar lymph nodes. Microscopically, the tumor tissue was composed of malignant cells forming vascular channels admixed with solid areas. Histo- and immunohistochemically, no mesothelial characteristics were evident. Factor VHI-related antigen and Ulex'europaeus I lectin were positive, implying that the tumor was of vascular origin. Grossly, and in part microscopically, this case resembled malignant diffuse mesothelioma, indicating that pericardial angiosarcoma may sometimes mimick malignant mesothelioma. ACTA PATHOL JPN 38: 1345-1351, 1988.     

Visual spatial attention to stimuli presented on the vertical and horizontal meridian: An ERP study

In the first experiment, 48 subjects carried out a visual spatial attention task. Stimuli were presented at the vertical meridian, either above or below a fixation dot, and the subjects were instructed to attend to one of these stimulus positions and ignore the other position. In three different conditions, the distances between stimulus positions and fixation were 0.5°, 0.9°, and 1.3°. Subjects searched for the presence of prememorized target letters at the attended location: memory load was one or four items in different conditions. The P1/N1 enhancement typically found on the horizontal dimension was not observed on the vertical dimension. Instead, a positive shift of the attended compared with the unattended stimuli was found, which was most prominent at anterior electrodes. This positivity showed effects of the distance manipulation. The N2b-P3a effect of attention and the effect of memory load (search negativity) normally present in this kind of selective search task were also found. Reaction times were faster when attention was directed above fixation than when it was directed below fixation. The event-related potential data suggested that this difference could be attributed to a more efficient neglecting of irrelevant stimuli presented below fixation. In Experiment 2, we examined whether the absence of the P1/N1 enhancement as the result of spatial attention in Experiment 1 could be attributed to (a) the presentation of stimuli along the vertical meridian instead of along the horizontal meridian, (b) the use of midline electrodes instead of lateralized electrodes, and (c) the relatively small spatial separation between the relevant and irrelevant stimuli. Twelve subjects searched for the presence of a single target letter at an attended position in three different conditions. In two of the conditions the letters were presented to the left or right of fixation. The distance between fixation and the stimulus positions was 1.3° in one of these conditions and 3° in the other condition. In the third condition, the stimuli were presented at 3° above or below fixation. In all three conditions effects similar to those in Experiment 1 were observed. In addition, in all three conditions an enhancement of the P1 and N1 components was found at two lateral occipitotemporal electrodes.     

人皮肤内神经-肥大细胞联接在经络线上的发现 Ⅱ“传入性”神经-肥大细胞联接和伴同传出性轴突的薛旺细胞

本研究取材于人的皮肤,电镜常规方法处理。发现人皮肤内有两种类型的神经肥大细胞联接。提示可能分别为传出性和传入性的,或暂称为A型和B型联接,分别报告于上篇和本篇中。 B型联接的构造特点是,脱开薛旺鞘样长带包被的轴突来到肥大细胞近旁,突进细胞体中。轴突终末的一部分被胞质唇封盖起来,终末周围的轴膜与细胞质膜形成联接的双层膜。无肥大细胞表面皱褶参与其形成,无线粒体和显明的囊泡存在终末之内,无薛旺细胞包被轴突终末。薛旺细胞伴同A型联接出现,可与肥大细胞紧密接触。胞质内有狭缝系统和粗面内质网片断,能拖出长尾,估计将过渡为鞘膜。薛旺细胞不是间织细胞,这里的间织细胞应是成纤维细胞。     

局部晚期肺癌外科手术治疗(附18例报告)

目的为提高晚期肺癌患者的外科手术切除率及提高手术疗效，总结18例晚期肺癌患者手术治疗中切开心包处理肺静脉或切除部分左心房的经验。方法对18例晚期肺癌患者施行肺叶或全肺切除时，在心包内处理肺静脉或切除部分左心房。左肺下叶切除5例、左全肺切除3例、右肺中下叶切除4例、右肺下叶切除4例、右全肺切除2例；术中发现13例患者的肺静脉根部有癌侵犯或有癌栓，在心包外元法常规处理肺静脉，在切开心包后可较满意地处理肺静脉，切开心包后发现其中有9例明显有左心房侵犯，行肺切除的同时切除部分左房；5例虽可在心包外处理，但癌肿离肺静脉根部太近处理肺静脉困难，而切开心包后处理肺静脉很轻松。结果18例均无手术死亡，术后有2例发生心律失常，2例并发肺炎，1年生存率61．2％（11／18）、3年生存率38．8％（7／18）、2例生存〉5年。结论晚期肺癌累及肺静脉根部或左心房时应切开心包处理肺静脉或同时切除部分左心房以达到肿瘤学上的根治性切除，从而延长病人的寿命。     

心包内处理肺静脉根部或切除部分左房在晚期肺癌手术中的应用

目的:探讨切开心包处理肺静脉或切除部分左心房对提高晚期肺癌患者的外科手术切除率及提高手术疗效的作用.方法:对21例晚期肺癌患者施行肺叶或全肺切除时,在心包内处理肺静脉或切除部分左心房.其中左肺下叶切除6例、左全肺切除4例、右肺中下叶切除6例、右肺下叶切除3例、右全肺切除2例.结果:21例均手术顺利;术后并发心律失常2例,肺炎2例,均治愈.本组1年生存率61.9%(13/21)、3年生存率38.1%(8/21),其中2例生存＞5 a.结论:晚期肺癌累及肺静脉根部或左心房时,通过切开心包处理肺静脉或同时切除部分左心房可提高肿瘤的根治率.     

Congenital absence of the pericardium and its relationship to the ligamentum arteriosum

Summary An anatomic and embryologic study of congenital absence of the pericardium and the relationship of the ligamentum arteriosum to this defect was carried out by the authors. A case report is presented to clinically correlate the anatomic and radiologic findings in this anomaly. The authors propose that visualization of the ligamentum arteriosum by computed tomography is a characteristic sign for congenital absence of the left pericardium.

---

Absence congénitale de péricarde, ses relations avec le ligament artériel

Résumé Les auteurs ont effectué une étude anatomique et embryologique de l'absence congénitale du péricarde et des relations entre le ligament artériel et cette absence. Ils rapportent une observation à propos de laquelle ils établisent les corrélations cliniques des données anatomiques et radiologiques de cette variation. Ils suggèrent que la visualisation du ligament artériel par tomodensitométrie soit interprétée comme un signe caractéristique de l'absence congénitale du péricarde gauche.

     

32P整体放射自显影技术用于人体十二经脉循行路线穴位的示踪

对人体十二经脉进行循行路线的示踪研究。方法用＾３２Ｐ整体放射自显影技术,对２２０例例骨病患者（其中手三阴极,三阳经和足三阳经各３０例,足三阴经１３０例）进行循行路线穴位示踪。结果阳性１７６例,阳性率８０％。其中出现点状放射自显影像者８例,占线状放射自显影像者１例。结和出的β射线在机体软组织中的有效射程仅４ｍｍ,整体放射自显像表明,＾３２Ｐ只能在人体皮肤或皮下２－３ｍｍ深度中运行,提示十二指脉循行路